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1.
Pediatrics ; 149(6)2022 06 01.
Article in English | MEDLINE | ID: covidwho-1760010

ABSTRACT

Nonrespiratory conditions related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have been largely described. Ileocolic intussusception has been reported in association with SARS-CoV-2 infection in 10 children, raising the possibility of an etiopathologic role for the virus, but none of these cases documented tissue pathology that would have supported SARS-CoV-2 intestinal inflammation. We report 2 cases of intussusception in patients with SARS-CoV-2 infection who were treated at different pediatric tertiary centers in Europe and provide evidence of the presence of the virus in mesenteric and intestinal tissues of the patients.


Subject(s)
COVID-19 , Intussusception , COVID-19/complications , Child , Europe , Humans , Infant , Intussusception/diagnostic imaging , Intussusception/etiology , SARS-CoV-2
2.
Pediatr Surg Int ; 38(3): 437-443, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1616123

ABSTRACT

PURPOSE: COVID-19 disease can manifest with intussusception in pediatric patients, but prevalence of abnormalities on ultrasounds performed for intussusception is uncertain. We aim to report our experience in children with COVID-19 presenting with suspected intussusception imaged with ultrasound. METHODS: Children under 18 years who had an ultrasound for possible intussusception underwent retrospective analysis and were tested for COVID-19 between April 1 and December 14, 2020. Patients' demographic, clinical, radiological and surgical characteristics were reviewed. RESULTS: Twenty-four COVID-19-positive patients were identified; 19 boys with mean age 3 years (range: 3 months-18 years). Ultrasound was abnormal in 11 patients (11/24, 46%). Sonographic features of enterocolitis were documented in seven children (7/24, 29%). Three boys (3/24, 13%) were found to have ileocolic intussusception on ultrasound and underwent air enema with failed reduction (3/3, 100%), precipitating surgical reductions, all with favorable outcomes. One patient (1/24, 4%) was found to have a long segment of persistent small bowel-small bowel intussusception which was surgically repaired. CONCLUSION: Given the known association between failed reduction at air enema and delayed presentation, heightened awareness for intussusception in the setting of COVID-19 should be maintained, though more often, the etiology was attributed to other GI manifestations of COVID-19.


Subject(s)
COVID-19 , Ileal Diseases , Intussusception , Adolescent , Child , Enema , Humans , Ileal Diseases/diagnostic imaging , Ileal Diseases/etiology , Ileal Diseases/surgery , Infant , Intussusception/diagnostic imaging , Intussusception/surgery , Male , Retrospective Studies , SARS-CoV-2 , Treatment Outcome
3.
Pediatr Radiol ; 52(3): 453-459, 2022 03.
Article in English | MEDLINE | ID: covidwho-1460301

ABSTRACT

BACKGROUND: The causes of idiopathic ileocolic intussusception are unknown, with infection as the most likely culprit. Recently, social distancing measures were implemented during the coronavirus disease 2019 (COVID-19) pandemic to decrease transmissible infectious diseases, creating an opportune setting to study the role of infection on the pathogenesis of intussusception on a population level. OBJECTIVE: To investigate the impact of social distancing on intussusception. MATERIALS AND METHODS: We retrospectively reviewed air contrast enemas and pylorus ultrasounds performed between March 2010 and March 2021 to identify cases of ileocolic intussusception and hypertrophic pyloric stenosis (HPS), using the latter as a negative control. The study time frame was divided into two periods: pre-pandemic (March 2010-February 2020) and pandemic (April 2020-March 2021). The number of cases that occurred in these two time periods were compared using the Poisson regression model. RESULTS: Of the 407 cases of idiopathic ileocolic intussusception identified, 396 occurred in the pre-pandemic time period (mean = 39.6 per 12-month period) and 11 occurred in the 12-month pandemic time period. The mean monthly number of intussusceptions showed a decline of 72% (95% confidence interval [CI] 49-85%) between the pre-pandemic and pandemic time periods (3.3 vs. 0.9 monthly cases; P < 0.001). In contrast, the mean monthly number of HPS did not differ significantly (P = 0.19). CONCLUSION: Social distancing-imposed to curb the spread of infection during the COVID-19 pandemic-resulted in a significant decline in ileocolic intussusception, lending strong support to the theory that infection is the dominant cause of intussusception.


Subject(s)
COVID-19 , Intussusception , Child , Humans , Intussusception/diagnostic imaging , Intussusception/epidemiology , Pandemics , Physical Distancing , Retrospective Studies , SARS-CoV-2
5.
Emerg Radiol ; 27(6): 761-764, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-834006

ABSTRACT

COVID-19, caused by the novel coronavirus strain SARS-CoV-2 that emerged in late 2019, has resulted in a global pandemic. COVID-19 was initially believed to occur less frequently in children with relatively mild disease. However, severe disease and varied presentations have been reported in infected children, one of such being intussusception. There have only been three reported cases of intussusception in the pediatric population infected with COVID-19. In this paper, we will discuss the management and treatment of a novel fourth case of COVID-19-associated intussusception. This case is the first reported in the USA and suggests that COVID-19 may be implicated in the development of intussusception. Pediatricians should consider the possibility of intussusception when a child with COVID-19 presents with abdominal pain.


Subject(s)
Coronavirus Infections/complications , Intussusception/diagnostic imaging , Intussusception/virology , Pneumonia, Viral/complications , Abdominal Pain , Betacoronavirus , COVID-19 , Diagnosis, Differential , Humans , Infant , Intussusception/therapy , Male , Pandemics , SARS-CoV-2 , United States
6.
J Pediatric Infect Dis Soc ; 9(4): 504-506, 2020 Sep 17.
Article in English | MEDLINE | ID: covidwho-783522

ABSTRACT

We note that intussusception was likely associated with severe acute respiratory syndrome coronavirus-2 infection in 2 infants in Wuhan and London. The intussusception was reduced by enemas in Wuhan; the outcome was fatal. The intussusception was not reduced by enemas in London and required surgery; the outcome was favorable.


Subject(s)
Coronavirus Infections/complications , Enema , Intussusception/therapy , Intussusception/virology , Pneumonia, Viral/complications , Betacoronavirus , COVID-19 , China , Fatal Outcome , Female , Humans , Infant , Intussusception/diagnostic imaging , London , Pandemics , SARS-CoV-2
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